PT - JOURNAL ARTICLE AU - Maisse Farhan AU - Ruth Brown AU - Maria Woloshynowych AU - Charles Vincent TI - The ABC of handover: a qualitative study to develop a new tool for handover in the emergency department AID - 10.1136/emermed-2011-200199 DP - 2012 Dec 01 TA - Emergency Medicine Journal PG - 941--946 VI - 29 IP - 12 4099 - http://emj.bmj.com/content/29/12/941.short 4100 - http://emj.bmj.com/content/29/12/941.full SO - Emerg Med J2012 Dec 01; 29 AB - Objectives This study identifies best practice for shift handover and introduces a new tool used to hand over clinical and operational issues at the end of a shift in the emergency department (ED). Methods Literature review, semi-structured interviews and observations of handover were used to develop a standardised process for handover. Participants were ED middle grades, consultants and senior nurses. Interviews were used to identify agreed best practice and derive a tool to classify the information into relevant sections. Results Interviews identified a variety of perceived current deficits in handover including a lack of standardised practice and structure. Participants provided examples of poor handover that were thought to have led to adverse events; these included delay in investigations and treatment for patients who were handed over with brief or inaccurate information. There was wide variation in the understanding of the meaning and purpose of shift handover, and differences were apparent according to the level of experience of the middle grades interviewed. The experts' responses were used to reach a unifying ‘best practice’ for the content of handover. This was then grouped under ABCDE headings to develop the ABC of handover tool. Conclusions A simple tool was developed to provide the basis for medical shift handover, which includes clinical and operational information necessary for efficiency and organisation of the next shift. The ABC of handover classifies shift information to be handed over under the ABCDE headings, which are easy to remember and highly relevant to emergency medicine.